替格瑞洛对冠心病PCI术后患者凝血功能及血清Hcy、TC、MPO水平的影响

Effects of ticagrelor on coagulation function and serum levels of Hcy,TC and MPO in patients with coronary heart disease after PCI

目的探讨替格瑞洛对冠心病PCI术后患者凝血功能及血清Hcy、TC、MPO水平的影响。方法选取2018年1月至2019年11月常州市第四人民医院收治的冠心病PCI术后患者80例,按照随机数字表法分为两组,各40例。对照组患者采用阿司匹林肠溶片联合氯吡格雷片治疗,试验组患者采用阿司匹林联合替格瑞洛片治疗。28 d为1个疗程,两组患者均治疗3个疗程。比较两组患者治疗前及治疗1、2、3个疗程后心功能指标LVEF变化;比较两组患者治疗前与治疗3个疗程后凝血功能APTT、TT、PT水平及血清Hcy、TC、MPO水平变化;比较两组患者治疗期间缺血与出血事件发生情况。结果与治疗前相比,治疗1、2、3个疗程后两组患者LVEF均呈升高趋势,且各时间点试验组均显著高于对照组;与治疗前相比,治疗3个疗程后两组患者PT、APTT均显著延长,且试验组显著短于对照组,TT显著延长,且试验组显著长于对照组,血清Hcy、TC、MPO水平均显著降低,且试验组显著低于对照组(均P<0.05);试验组患者缺血总发生率(2.50%)与出血事件总发生率(7.50%)分别低于对照组(12.50%、22.50%),但差异无统计学意义(P>0.05)。结论替格瑞洛可有效改善冠心病PCI术后患者的心功能及凝血功能,且可抑制炎症反应,减少术后出血与缺血时事件的发生,有利于患者快速康复。

Objective To investigate the effects of ticagrelor on coagulation function and serum Hcy,TC and MPO levels in patients with coronary heart disease after PCI.Methods A total of 80 patients with coronary heart disease after PCI admitted to the the Fourth People's Hospital of Changzhou from January 2018 to November 2019 were randomly divided into two groups according to the random number table method,with 40 cases in each.Patients in the control group were treated with aspirin enteric-coated tablets combined with clopidogrel tablets,and patients in the experimental group were treated with aspirin tablets combined with ticagrelor tablets.28 days was a course of treatment,and both groups of patients were treated for 3 courses.Compared the changes of heart function index LVEF before treatment and 1,2,3 courses after treatment between the two groups;Compared the levels of APTT,TT,PT and serum Hcy,TC,MPO before treatment and 3 courses after treatment between the two groups;Compared the occurrence of ischemia and bleeding events during treatment between the two groups.Results Compared with before treatment,the LVEF of patients in the two groups showed an increasing trend 1,2,3 courses after treatment,and the experimental group was significantly higher than the control group at each time point;Compared with before treatment,and the PT,APTT of the patients in the two groups after 3 courses of treatment significantly extended,and the experimental group was significantly shorter than the control group,TT significantly extended,and the experimental group was significantly longer than the control group,the serum Hcy,TC,and MPO levels significantly reduced,and the experimental group was significantly lower than the control group(all P<0.05);The total incidences of ischemia events(2.50%)and bleeding events(7.50%)in the experimental group were lower than those in the control group respectively(12.50%,22.50%),but the difference was not statistically significant(P>0.05).Conclusion Ticagrelor can effectively improve the heart function and coagulation function of patients with coronary heart disease after PCI,and can inhibit inflammation.reduce the occurrence of ischemia events and bleeding events,which is good for the patient's recover.